Healthcare Provider Details

I. General information

NPI: 1669587887
Provider Name (Legal Business Name): OBINNA OJI ODI PHARM-D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3527 RIVER WATCH PKWY
MARTINEZ GA
30907-2919
US

IV. Provider business mailing address

PO BOX 2851
AUGUSTA GA
30914-2851
US

V. Phone/Fax

Practice location:
  • Phone: 706-210-0091
  • Fax:
Mailing address:
  • Phone: 706-733-0188
  • Fax: 706-731-7258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH022692
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: